New Research Suggests HRT May Lower Heart Risks

WEDNESDAY, Oct. 10 (HealthDay News) -- New research suggests
that women who take hormone replacement therapy in the early stages
of menopause may have a reduced risk of heart attack, heart failure
or dying.

This apparent benefit comes without a heightened risk of cancer
or blood clots, the Danish researchers said. These health risks
have long been a concern of menopausal women and their doctors when
considering hormone therapy.

The study, published Oct. 9 in the
BMJ, even found evidence of a trend toward a lower risk of
breast cancer, although this was not statistically significant,
said study author Dr. Louise Lind Schierbeck.

However, two doctors not associated with the study said the
findings weren't enough to convince them to recommend hormone
replacement therapy (HRT) to head off heart problems. But they --
and many doctors -- would prescribe low doses of the therapy for
short durations to treat menopausal symptoms such as poor sleep or
hot flashes.

The new study comes on the heels of two other studies, one
finding that HRT was safe for the heart and the other concluding
that it did not worsen memory in younger women taking it.

Women have shied away from hormone therapy since the landmark
Women's Health Initiative study found elevated risks of breast
cancer, heart disease and other health problems among women taking
estrogen plus progestin, a synthetic form of progesterone. That
study was halted early because of the results, published in
2002.

For this latest study, about 1,000 women aged 45 to 58 who were
recently menopausal or had perimenopausal symptoms, such as hot
flashes and irregular periods, were randomly selected to receive
either HRT or an inactive placebo.

Participants took the therapy for an average of a decade, at
which point they had a 50 percent decreased risk of a
cardiovascular event or death, said Schierbeck, who is with
Bispebjerg Hospital in Copenhagen. Six years after women had
stopped taking HRT, the risk was still reduced 40 percent, she
added.

Schierbeck conducted the study while at Hvidovre Hospital, also
in Copenhagen. She said that longer follow-up research is needed to
verify the breast cancer results.

This study differs from the Women's Health Initiative (WHI) in
several important ways. The women in this study were much younger
than in the WHI (an average age of 50 versus 64) and were given a
differently formulated estrogen.

The difference in age and time since menopause were probably the
main reasons for the differences in the studies, Schierbeck
said.

But one analysis from the WHI, which only looked at women
younger than 60, also found a reduction in heart disease and death,
albeit one that was not statistically significant.

HRT has been shown to lower cholesterol levels, improve blood
vessel function and keep body weight down, all of which might
contribute to a reduction in heart disease.

Dr. Suzanne Steinbaum, director of women and heart disease at
Lenox Hill Hospital in New York City, said the new study can offer
a "little bit of peace of mind" to women who are "recently
postmenopausal who are really symptomatic with mood swings, hot
flashes and difficulty sleeping and concentrating."

But, she would not prescribe HRT to prevent heart disease based
on these results.

Dr. Mary Ann McLaughlin, director of the cardiac health program
at Mount Sinai Medical Center in New York City, agreed. "I don't
think this is enough to change recommendations," she said.

"I wouldn't recommend HRT to postmenopausal women to reduce heart attacks," McLaughlin added. "These results make me feel more confident that some women may benefit from estrogen therapy, but until I figure out which particular women those are, I would not recommend a carte blanche giving estrogen again to prevent heart attacks.

"In the next five years, we'll be able to better define which women would benefit and which would be harmed by estrogen," McLaughlin said. "We're not there yet."

Schierbeck said that international societies are currently
weighing the risks and benefits of hormone replacement therapy, to
be able to issue future recommendations.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.